ABSTRACT
The preliminary results of a simple technique used in the treatment of fistula in ano are presented. It involved the insertion of a multi-strand stainless steel wire in the fistulous track and its weekly repeated tightening, and has been used in 37 patients with low anal and 15 patients with high anal fistulae. After completion of the procedure, 49 cases [94.2%] were completely healed while, in 3 cases [two high anal and one low anal fistulae] the discharge persisted. Re-wiring was performed in the 3 cases with successful outcome in two of them while one case of high anal fistula failed to benefit from the procedure. During the follow-up period [average, 18.4 months], 4 patients [7.8%] developed recurrence of their fistulae within 6 months after the completion of the procedure. Three of patients with low anal fistulae were successfully treated by re-wiring while the fourth patient with high anal fistula failed to respond. The overall success rate of Wiring technique in curing all types of anal fistulae was 96.2%. None of the patients complained of temporary or permanent incontinence for flatus or faeces while, the wire was in situ or throughout the whole follow-up period. So, we conclude that wiring of the fistulous track is a safe technique and with highly satisfactory results in the treatment of various types of fistulae in ano. As the procedure does not require special skills or prolonged hospitalization and as it does not entail excision of any tissue, we recommend it as a primary treatment for all types of anal fistula. However, we advise longer follow-up for the proper evaluation of the procedure